Hybrid closed-loop glucose control compared with sensor augmented pump therapy in older adults with type 1 diabetes: an open-label multicentre, multinational, randomised, crossover study

Impact of the CamAPS FX hybrid closed‐loop insulin delivery system on sleep traits in older adults with type 1 diabetes

“…During the HCL period, the association between longer time spent in hyperglycaemia and shorter sleep onset latency could also be explained by individuals perceiving a greater sense of safety through having a lower perceived risk of night‐time hypoglycaemia, and thus falling asleep more easily. Longer time spent in hyperglycaemia could potentially worsen other sleep traits through mechanisms including increased alarms, nocturia, painful neuropathy, and restless legs syndrome, but we observed no such relationships, possibly because the degree of hyperglycaemia was modest, and few participants had diabetes‐related complications 7 …”

“…ing with longer sleep onset latency is plausibly explained by anxiety and fear of hypoglycaemia induced by low sensor glucose values, which may have delayed sleep through sympathetic nervous system activation and stress hormone release.During the HCL period, the association between longer time spent in hyperglycaemia and shorter sleep onset latency could also be explained by individuals perceiving a greater sense of safety through having a lower perceived risk of night-time hypoglycaemia, and thus falling asleep more easily. Longer time spent in hyperglycaemia could potentially worsen other sleep traits through mechanisms including increased alarms, nocturia, painful neuropathy, and restless legs syndrome, but we observed no such relationships, possibly because the degree of hyperglycaemia was modest, and few participants had diabetes-related complications 7. Our study's strengths include the randomized crossover study design which minimized risk of confounding.…”

Closed-loop therapy in older adults with type 1 diabetes: hypoglycaemia benefits and risk stratification – Authors' reply

“…2 In this study, they and their colleagues report that, relative to sensor-augmented pump therapy, a hybrid closed-loop insulin delivery strategy was associated with significant improvements in time in range measured by continuous glucose monitoring in older adults with type 1 diabetes. Moreover, and in contrast to the study of Charlotte Boughton and colleagues, 3 they report small but significant decreases in hypoglycaemia with a hybrid closed-loop strategy. Both studies enrolled older individuals with long-standing type 1 diabetes who were, nevertheless, well controlled (mean HbA 1c around 7•4%) and both used a crossover design comparing hybrid closed-loop insulin delivery with sensor-augmented pump therapy.…”

Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

“…As previously mentioned, evidence from numerous RCTs and real-world studies support the safety and efficacy of use of AID systems in young, school-aged pediatric populations and in adolescent/adult populations ( 2 , 3 , 5 , 17 , 18 , 20 , 23 , 30 , 35 , 46 , 56 , 57 , 63–67 , 70–73 , 89 , 90 ). Although some studies included children from the age of 1 year, and adult populations older than 65 years ( 2 , 4 , 23 , 27 , 29 , 35 , 37 , 68 , 69 , 89 , 91 ), additional research is required to truly estimate the impact of AID in these age groups.…”